A case report of emphysematous pyelonephritis and review of the literature

Abstract EN

We report a case of a 66-year old male patient, married, not smoker, with past history of diabetes mellitus for 25-year duration, and hypertension on oral medications, admitted to medical department as a case of urosepsis and renal impairment, he was complaining of bilateral loin pain, more in left side, continuous, radiated to back, associated with dysuria, bad appetite and fever for two weeks duration.

Laboratory results: WBC was 17.000, serum createnine: 364 umol/L.

EPN is a gas-producing necrotizing bacterial infection that involves the renal parenchyma and perirenal tissue with a variable clinical picture ranging from mild abdominal pain to septic shock.

The majority of cases occur in diabetics with poor glycemic control while a small percentage may be due to urinary tract obstruction that results in the presence of gas in the renal parenchyma, collecting system or perinephric tissue.

We report a case of EPN which was managed by conservative treatment with antibiotics and control of diabetes with internal drainage of both kidneys.